Form 1318 Driver Training Assessment: EMS Agency

APPENDIX D1

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX

Driver Training Assessment: EMS Agency
Driver Training Assessment: Emergency Medical Services
This collection of information is voluntary and will be used to document the laws, rules and regulations governing the driving of ambulances,
including training and education requirements. The results of the study will be used to develop programs designed to improve emergency medical
services. A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for
failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information
displays a current valid OMB Control Number. The OMB Control Number for this information collection is XXXX-XXXX. Public reporting for this
collection of information is estimated to be approximately 15 minutes per response, including the time for reviewing instructions, completing and
reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden
estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance
Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Washington, DC, 20590

The National Highway Traffic Safety Administration
(NHTSA) is interested in characterizing the current state of
emergency vehicle operator training for ambulance
operators across the United States. We are asking that
one person from your EMS agency who is either in charge
of or at least very familiar with ambulance operations at
your agency complete this survey. In the following pages,
you will be asked a variety of questions about the training
provided to anyone who gets behind the wheel and
operates an ambulance on the roadway for your agency.

The entire survey should take less than 15 minutes to
complete.
Participation in the study is voluntary, and your responses
will remain anonymous. Any reports will only include
results at the group level.

Thank you for your assistance.

NHTSA Form 1318

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OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Demographics/Core

* 1. Does your agency operate ground ambulances?
Yes
No (survey will end)

* 2. In which State does your agency operate?
State

-- select state --

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Demographics/Core - You

* 3. Please rate your knowledge of ambulance operations
at your agency.
Extensive knowledge
Moderate knowledge
Limited knowledge
No knowledge

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Demographics/Core - You

4. What is your primary role at this agency or organization?
Educator/Preceptor
Administrator/Manager
First-line Supervisor
Patient Care Provider
Emergency Vehicle Operator
Other (please specify)

5. How many years have you been in this position?

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Demographics/Core - Your Agency

6. Which of the following best describes your EMS
agency?
Hospital
Fire Department
Government, non-Fire Department, non-Hospital
Tribal
Private
Association
Other (please specify)

7. What is the tax status of your agency?
For profit
Not-for-profit
Government
Unincorporated
Other (please specify)

8. Which of the following best describes the community in
which your agency does most of its EMS work?
Rural area (less than 2,500 people)
Small town (2,500-24,999 people)
Medium town (25,000-74,999 people)
Large town (75,000-149,999 people)
Mid-sized city (less than 500,000 people)
Large city (500,000 or more people)

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Demographics/Core - Your Agency

9. What percentage of your agency is made up of
volunteers (i.e., individuals who are not issued a W-2
form even if they receive some form of compensation
other than wages)?
0%- there are no volunteers
Less than 25%
26-50%
51-75%
76-100%
Don't know

10. Approximately how many years has your agency been operating ambulances?
(If you don't know, enter "DK")

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Demographics/Core - Your Agency

11. Check all of the following that describe the EMS and
transport services provided by your agency.
911 response with transport capability
911 response without transport capability
Air medical
Hazmat
Medical transport (convalescent)
Paramedic intercept
Rescue
Specialty care transport
Don't know

12. Which of the following best describes the calls to
which your agency's ambulances respond?
All are emergency calls
Most are emergency calls
About equal numbers of emergency calls and scheduled transports
Most are scheduled transports
All are scheduled transports
Don't know

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Demographics/Core - Your Agency

13. How many of the following types of ambulances does
your agency operate? (Enter whole numbers, or if you
don't know enter "DK")
Type 1 (Cab chassis furnished with a modular ambulance body)

Type 2 (Long wheelbase van with integral cab body)

Type 3 (Cutaway van/truck chassis with integrated modular ambulance
body)

Other (Please specify number)

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Demographics/Core - Fatigue Risk Management Plan

14. Does your agency currently have a Fatigue Risk
Management Plan (FRMP)?
Yes
No
Don't know

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Demographics/Core - Fatigue Risk Management Plan

15. Check all of the following that are features of your
FRMP.
We have a documented FRMP
We have a detailed FRMP
We have a documented statement of working hours
We have limits on overtime hours
We have a FRMP promotion and communications strategy
We have processes for continuous evaluation and improvement
(e.g. hazard ID, evaluation, and sources of data)
We have a procedure for paid and volunteer staff to self-report
fatigue
We have a procedure for error/adverse incident or crash
investigations where fatigue is suspected as a contributing factor
Other (Please describe other features of your FRMP)

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Demographics/Core - Driver Licensing Requirements

* 16. Indicate if your agency has the following driver licensing, certification, or
endorsement requirements for ambulance operators by checking the
appropriate boxes below.
Standard operator class (regular driver's license)
Commercial class (any form of CDL)
Ambulance-specific license
Ambulance-specific certificate
Ambulance-specific endorsement
Emergency response vehicle (EMS) specific license
Emergency response vehicle (EMS) specific certificate
Emergency response vehicle (EMS) specific endorsement
None
Don't know
Other (please specify)

NHTSA Form 1318

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OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Demographics/Core - Driving History Check

17. How often does your Agency review driving records
of your ambulance operators? Check all that apply.
Never
As a condition or prerequisite to hiring/affiliation
Based on agency/leadership determination that relevant
information may be found
Once per year
More than once per year
Don't know

18. What events prevent an individual from being allowed
to operate an ambulance? Check all that apply.
Crash
DUI/DWI
Speeding Violation(s)
Reckless Driving
Other Moving Violation(s)
Don't know
Other (please specify)

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training

* 19. Do ambulance operators at your agency complete
emergency vehicle operator training?
Yes, it's a requirement
Yes, but it's not a requirement
No
Don't know

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Your Role

* 20. Please rate your knowledge of the ambulance
operator training conducted at your agency.
Extensive knowledge
Moderate knowledge
Limited knowledge
No knowledge

NHTSA Form 1318

14

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Program Description

21. How structured is the driver training for ambulance
operators?
Formal/structured training with a defined curriculum
Informal/unstructured training
Don't know

22. Who developed your driver training program?
Developed our own program for in-house use
Use a program that was developed by someone else
Don't know

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Program Description

23. If applicable, please tell us the name of the training program your agency uses?

24. If the training program is based on any standards or best practices, check
all that are applicable below.
National Standard Curriculum-EVOC, 1995 Edition, U.S. Department of Transportation
Department of Homeland Security (DHS) Driver Performance Best Practices
U.S. Fire Administration (USFA)/FEMA Traffic Incident Management Systems, FA-330
U.S. Fire Administration/International Association of Fire Fighters (USFA/IAFF) Vehicle
Safety Program
National Safety Council Defensive Driving Course for Specialty Vehicles
Volunteer Fire Insurance Service (VFIS) suggested curriculum and cone course
None
Don't know
Other (please specify)

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Program Description

25. Which of the following best describes the ambulance
operator training?
Specific to Ambulances
Specific by type of ambulance (Type 1,2, or 3)
Based on fire or police emergency vehicles
Don't know

26. Where do ambulance operators receive driver
training instruction? Check all that apply.
Classroom
Behind-the-wheel on track or closed course
Behind-the-wheel on live roadway
Simulator
Online/Internet
Don't know

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Program Description

27. How many TOTAL hours is the ambulance operator training?

28. How many hours of each of the following does the
ambulance operator training include? If none, please
enter 0.
Classroom
Behind-the-wheel closed course
Behind-the-wheel live roadway
Simulator training
Online/Internet

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Training Administration

29. Who conducts the driver training? Check all that apply.
In-house employee or volunteer
External instructor comes to our agency
Instructor at another EMS agency
Instructor at a private school/academy
Instructor at a public school/academy
Internet/Online instructor
Don't know
Other (please specify)

30. Which of the following qualifications/certifications do
lead instructors have? Check all that apply.
Emergency Vehicle Operator Course (EVOC) instructor (State
certified)
Emergency Vehicle Operator Course (EVOC) instructor (Other
certified)
EMS Instructor (State certified)
EMS Instructor (Other certified)
Basic Driving Instructor (State certified)
Basic Driving Instructor (Other certified)
On-the-job experience
Fire Instructor 1
None
Don't know
Other (please specify)

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Training Content

* 31. Indicate if your agency's ambulance operator training includes the
following topics by checking the appropriate boxes below.
Driving Procedures (vehicle handling, safe speed, changing lanes, passing, intersections,
turning, right of way, parking, navigation, etc.)
Special Circumstance Driving Procedures (near miss recovery, inclement weather, use of
lights and sirens, using back-up spotter, accident avoidance methods, close calls)
Communication Responsibilities
Traffic Incident Management
Emergency Scene/Accident Vehicle Staging
Vehicle Readiness
Managing Fatigue
Distraction Management
None
Don't know
Other (please specify)

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Training Criterion and Evaluation

* 32. Which of the following tests must an operator pass
before driving an ambulance?
Written test
Driving test
Both Written and Driving Test
None
Don't know

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Training Criterion and Evaluation

33. Who determines the minimum scores needed to pass
the tests? Check all that apply.
Our Agency
State
Insurance Agency
Don't know
Other (please specify)

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Training Criterion and Evaluation

34. Are volunteer ambulance operators in your agency trained to the
same standard as non-volunteers?
Yes
No (please tell us how they differ below )
Not applicable (no volunteers)
Don't know
If you checked "No" above, please explain:

35. How have you evaluated the effectiveness of your
ambulance operator driver training program? Check all
that apply.
Monitor crash rates, response times, etc.
Survey trainee satisfaction
Formal in-house review
Independent evaluation
Never evaluated
Don't know

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Refresher Training

36. How often do ambulance operators at your agency
complete refresher driver training?
Every 6 months
Every year
Every 18 months
Every 2 years
Never
Don't Know
Other (Please specify how often)

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Refresher Training

37. How many years has it been since your ambulance operator training was revised?
(Enter whole numbers, or if you don't know enter "DK")

38. If someone has a crash while driving an ambulance,
does your agency require remedial operator training?
Yes
On a case-by-case basis
No
Don't know

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Check Rides

* 39. Does your agency conduct “check rides” (senior staff
member rides along to determine if ambulance operator
is fit to drive)?
Yes
No
Don't know

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Check Rides

40. What is evaluated as part of the check ride? Check all that apply.
Driving Procedures (vehicle handling, safe speed, changing lanes, passing, intersections,
turning, right of way, parking, navigation, etc.)
Special Circumstance Driving Procedures (near miss recovery, inclement weather, use of
lights and sirens, using back-up spotter, accident avoidance methods, close calls)
Communication Responsibilities
Traffic Incident Management
Emergency Scene/Accident Vehicle Staging
Vehicle Readiness
Managing Fatigue
Distraction Management
None
Don’t Know
Other (please specify)

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Driver Training - Materials for Upload

41. Do you have a driver training manual or other driving
related materials for ambulance operators to reference?
Check all that apply.
Yes, our agency provides materials
Yes, the external training program provides materials
Yes, the State provides materials
No
Don't know

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NHTSA Form 1318

OMB Control No. 2127-XXXX
Expiration Date XX/XX/XXXX
Driver Training Assessment: EMS Agency
Training Material Upload Link

If you have electronic driver training materials that you are willing to
share, please upload them by clicking on the link below. You may also
cut and paste the link into a new browser window.

Upload files here:
https://www.dropbox.com/request/UQOsjRikzxpZTvBZYreO

If you have paper-based materials that you are willing to share, please
e-mail Dr. Kristopher Korbelak at [email protected]. We will be
happy to arrange for and cover the cost of the shipping of any material
that may be of use to the project.

After you have finished uploading materials, please click Done
below.

NHTSA Form 1318

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